Keep an eye on this blog while we keep an eye on whether we will all have affordable care or not.

Tuesday, March 13, 2018

Killing the ACA in a Short Term

Remember Tom Price, the orthopedic surgeon/Secretary of
Health and Human Services, who wanted to rip the heart out of the Affordable
Care Act (ACA) but instead was sent packing after racking up at least $400,000 taking
private jets for short flights (eg. DC to Philadelphia)?

Well, you may not have paid much attention to his replacement,
Alex Azar, but we all should.He's a bit
more complicated than his predecessor.He
was the Deputy HHS Secretary under George Bush, followed by a stint as
President of the US division of Eli Lilly, a giant drug company. For better or worse, he has far
deeper knowledge of the health care system than the bone carpenter from
Oklahoma. And he could be far worse.

He is an abortion opponent, has a history of vocal opposition
to the Affordable Care Act, and he's allowing states to impose work
requirements on Medicaid recipients.

But so far he's enforcing the regulations, including those introduced under Obama.The latest
example was his rejection of Idaho's outright illegal and jug headed decision to simply ignore the
ACA requirements.Under Governor
Otter, Idaho insurers could sell
plans without its essential benefits, notably maternity care and vision
and dental for kids. These plans would have deductibles in the
thousands of dollars and cap annual benefits at $1 million—also not allowed
under the ACA. Premiums for older adults compared to younger one would increase
significantly.And for people with
pre-existing conditions, premiums would go up by 50%; in fact, these individuals wouldn't
get any coverage at all for a year if they had been uninsured for 63 days.

Blue Cross of Idaho called these "Freedom Blue"plans.Question, why does
"Freedom" for Republicans generally involve the rich being free to
take anything they want and the poor being free of basic rights and
necessities?

But, although Azar did a good thing in blocking Governor
Otter's plan and therefore other state governments from adopting similar ones,
he has proposed a nefarious play that could undermine ACA's entire foundation—the extension of short term plans.

These plans are currently allowed under the ACA as temporary
insurance for people who need it but have missed the open
enrollment period for coverage under the health exchanges. They are intended to provide
insurance for three months at most and they don't need to cover the following:

·Pre-existing conditions, including chronic pain.

·Essential benefits

·Preventive care

·Prescription drugs outside the hospital

The
short-term plans can’t be renewed or used as full-time coverage without paying
a penalty.They are only intended to fill
the gap until a person can be covered under a full ACA-compliant insurance package.

Well, no surprise, the Trump administration has been salivating over these weak but legal plans, and Azar now intends to Frankenstein
them into year-long and renewable Monsters. (Several insurers have already sidestepped the rule by packaging consecutive 90-day
plans, with a one-time review of a patient's medical history.) Thus, these plans, originally created to be a temporary aid, will become the
Republican's grotesque tools for stomping on the ACA's critical benefits,
weakening the market for healthy people and increasing premiums, including dramatically for those with pre-existing conditions. Once again we become vulnerable to the
exorbitant costs of our obscene medical system.

About Us

Carol Peckham has spent over 30 years in medical publishing. At the start of this career, she served as Publisher of Scientific American Medicine as a Vice President of Scientific American, Inc. After 15 years, she left to start her own company, Nidus Information Services, where she and her partner launched Well-Connected, a series of 103 in-depth white papers for patients, available in print and on the Internet. After 10 years, they sold their company, and subsequently joined Medscape, the professional arm of WebMD. Peckham served as Director of Editorial Development for another decade. She is now retired and living near Hudson, NY, where she has become active in encouraging universal health care.